Patient Account Representative

Gillette Children's•Saint Paul, MN

19h•Hybrid

About The Position

This position provides support for recovering back-end revenue by ensuring timely and accurate processing of patient accounts to both third party payors and patients/guarantors. Promotes and maintains professional and positive patient and family experience as the last impression of the organization. The hourly wage for this opportunity is $21.88/hour to $30.87/hour, with a median wage of $25.74/hour. Pay is dependent on several factors including relevant work experience, education, certification & licensure, and internal equity. Hourly pay is just one part of the compensation package for employees. Gillette supports career progression and offers a competitive benefits package that includes a retirement savings match, tuition and certification reimbursement, paid time off, and health and wellness benefits for 0.5 FTE and above. At Gillette Children’s, we foster a culture where every team member feels a sense of belonging and purpose. We are dedicated to building an environment where all feel welcomed, respected, and supported. Our values are embedded at the heart of our culture. We act first from love, embrace the bigger picture, and work side-by-side with our patients, families, and colleagues to help every child create their own story. Together, we work to ensure patients of all backgrounds and abilities reach their full potential. Gillette Children's is an equal opportunity employer and will not discriminate against any employee or applicant for employment because of an individual's race, color, creed, sex, religion, national origin, age, disability, marital status, familial status, genetic information, status with regard to public assistance, sexual orientation or gender identity, military status or any other class protected by federal, state or local laws. Gillette Children’s is a global beacon of care for patients with brain, bone and movement conditions that start in childhood. Our research, treatment and supportive technologies enable every child to lead a full life defined by their dreams, not their diagnoses. To learn more about working at Gillette Children's, please visit https://www.gillettechildrens.org/careers . Gillette Children's participates in the U.S. Department of Homeland Security (DHS) E-Verify program which is an internet-based employment eligibility verification system operated by the U.S. Citizenship and Immigration Services. If E-Verify cannot confirm that you are authorized to work, Gillette will give you written instructions and an opportunity to contact DHS or the Social Security Administration (SSA) to resolve the issue before Gillette takes any further action. Please visit https://www.e-verify.gov/ for further details regarding e-verify.

Requirements

High School Diploma/ GED
1-3 years’ experience in customer service, administrative or healthcare setting
Knowledge & understanding of medical terminology
Knowledge & understanding of commercial insurance carriers and standard insurance forms
Strong computer aptitude including knowledge of Microsoft Office (Word, Excel, Outlook)
Demonstrated strength in customer service, organization, attention to detail and the ability to work independently
Demonstrated ability to work and problem solve in a collaborative manner within the department and organization
Demonstrated ability to multi-task and respond quickly/reprioritize changing needs

Nice To Haves

Advanced education (Associate or Bachelors)
2+ years of medical billing or coding experience that includes exposure to payor DME Billing Experience

Responsibilities

Resolving front end claim edits to ensure accurate and timely clean claim submission to third party payors for adjudication.
Following up on outstanding patient accounts to clarify reason or delayed and/or delinquent processing and resolving technical denials to ensure accurate and timely processing in order to reconcile outstanding balances.
Following up on claims submitted to payors for adjudication to ensure claim has been received and in process for payment or denial within 30-45 days of claim submission.
Following up on delinquent accounts after 30 days of no response with payors by calling and/or utilizing payor portals for clarification on delays.
Filing corrected claims when necessary using correct bill types/submission codes.
Working with peers and analysts as necessary to resolve claim issues.
Working with analysts and other departments to file claim appeals.
Processing hospital receivables in a timely and accurate manner.
Performing basic maintenance of patient accounts in EMR system as necessary.
Assessing outstanding balances for assigned accounts to determine proper course of action for obtaining payment and reconciling balance.
Meeting and maintaining quality and productivity metrics as well as Gillette CARES values as set by the department.
Independently completing annual training as assigned.
Completing self-assessment timely and with contributing comments.
Completing 80% of peer feedback for direct peers.